Effects of Different Local Anaesthetics on Oto-acoustic Emission Tests after Spinal Anaesthesia.

PURPOSE: To evaluate whether there is any effect of different local anaesthetic agents on hearing loss after spinal anaesthesia. METHODS: Thirty American Society of Anesthesiologists (ASA) I patients without a hearing problem were included in the study. Transient evoked oto-acoustic emissions (TEOAE) were examined. Patients were randomly separated into two groups: Group L, 15 mg isobaric levobupivacaine application and Group B, 15 mg isobaric bupivacaine application, for spinal anaesthesia. Oto-acoustic emission measurements were repeated on patients at the 24th hour after spinal anaesthesia application. RESULTS: No significant difference was found in the output values of the right and left ears according to the input values in group L at no kHz (p > 0.05). No significant difference was found in the output values of the right and left ears according to the input values in any kHz of Group B (p > 0.05). CONCLUSION: Fifteen milligrammes of isobaric bupivacaine and levobupivacaine had no significant difference on the effect of hearing loss after spinal anaesthesia. Hearing loss after spinal anaesthesia has many unknown issues, and deserves to be explored by performing many studies.

Transdermal methyl alcohol intoxication cause of pain relief.

A 60-year old female patient was found comatosed at home and taken to the hospital's Emergency Department by her relatives. It was learnt that she wrapped her knees with spirit-impregnated cotton pad for pain for one week. On physical examination, only a colour change of purple violet on her knees was noted. Metabolic acidosis with increased anion gap was detected by arterial blood analysis. The patient underwent haemodialysis. She was discharged from the hospital with no complaints, alert and rational following five days of follow-up treatment, with the diagnosis of methyl alcohol poisoning.

Transdermal methyl alcohol intoxication cause of pain relief / Intoxicación transdérmica con alcohol metílico tratando de aliviar un dolor

A 60-year old female patient was found comatosed at home and taken to the hospital's Emergency Department by her relatives. It was learnt that she wrapped her knees with spirit-impregnated cotton pad for pain for one week. On physical examination, only a colour change of purple violet on her knees was noted. Metabolic acidosis with increased anion gap was detected by arterial blood analysis. The patient underwent haemodialysis. She was discharged from the hospital with no complaints, alert and rational following five days of follow-up treatment, with the diagnosis of methyl alcohol poisoning.

Una paciente de 60 años de edad fue hallada en estado comatoso en su casa, y trasladada por sus familiares al departamento de emergencias del hospital. Se supo que la paciente había sentido dolor en sus rodillas, y las cubrió con almohadillas de algodón impregnadas de metanol por espacio de una semana. Al realizarse el examen físico, sólo se observó un cambio de color violeta púrpura en sus rodillas. El análisis de sangre arterial reveló acidosis metabólica con hiato iónico elevado. A la paciente se le practicó una hemodiálisis. Fue dada de alta del hospital sin dolencias, consciente, y en su sano juicio, luego de cinco días de seguimiento de su tratamiento, tras de haber sido diagnosticada con envenamiento por alcohol metílico.

Comparison of transcutaneous, arterial and end-tidal measurements of carbon dioxide during laparoscopic cholecystectomy in patients with chronic obstructive pulmonary disease.

OBJECTIVE: Transcutaneous, arterial and end-tidal measurements of carbon dioxide were compared in patients (American Society of Anesthesiology physical status classes II and III) with chronic obstructive pulmonary disease (COPD) who underwent laparoscopic cholecystectomy with carbon dioxide insufflation. METHODS: General anaesthesia was performed in all patients. The Sentec(®) system was used for transcutaneous monitoring of the partial pressure of carbon dioxide (TcPCO(2)). TcPCO(2) and arterial partial pressure of carbon dioxide (PaCO(2)) were recorded preoperatively, after induction of anaesthesia, during insufflation and postoperatively; end-tidal carbon dioxide (ETCO(2)) was recorded after induction and during insufflation. RESULTS: PaCO(2) increased during insufflation and reached a maximum at extubation. It declined within 20 min postoperatively but did not return to preoperative levels during this time. TcPCO(2) levels followed a similar pattern. ETCO(2) was significantly lower than PaCO(2) after induction and during insufflation. CONCLUSION: TcPCO(2) was a valid and practical measurement compared with ETCO(2). In patients with COPD undergoing laparoscopic cholecystectomy, TcPCO(2) and ETCO(2) could be used instead of arterial blood gas sampling.

Intra-articular injection of tenoxicam in rats: assessment of the local effects on the articular cartilage and synovium.

This study investigated the possible local adverse effects of intra-articular administration of tenoxicam in the rat knee joint. A total of 50 rats were given 0.25 ml of a standard preparation of tenoxicam by injection into the right knee joint and 0.25 ml of 0.9% saline solution by injection into the left knee joint as a control. Groups of 10 rats were killed 24 h, 48 h, 7 days, 14 days and 21 days after tenoxicam administration. Two rats were sham operated; one was killed on the first day and the other on the second day after this procedure. All the joints were prepared and sectioned for histological examination. Tissue loss and oedema were observed in the specimens obtained 24 h and 48 h after treatment with tenoxicam. No pathological changes were observed in the 7-day, 14-day and 21-day specimens, or in the control joints. Caution should be exercised when using intra-articular tenoxicam for post-operative analgesia.

[Thalamic pain syndrome]. / Talamik agri sendromu.

Central pain is a chronic pain due to various causes, with accompanying neurological symptoms and often unresponsive to medical therapy. Pain management and results in a 31 years old female patient with a diagnosis of thalamic pain syndrome, which is one of the causes of central pain is analysed in this article.

Neurotoxicity of midazolam in the rabbit.

Safe and efficient use of spinal drugs requires neurotoxicologic animal studies before ethical application. We have evaluated the neurotoxicologic interruptions of intrathecal administration of midazolam in rabbits. Eighteen white New Zealand rabbits were randomly assigned into three groups consisting of six rabbits each. In conscious animals, 0.3 ml 0.9% normal saline solution, 0.3 ml 0.1% midazolam (Roche, Dormicum) or 0.3 ml preservative free midazolam were intrathecally administered. Light and fluorescence microscopy evaluations were performed on transverse spinal cord sections by a neurohistopathologist in a blind fashion. Midazolam and preservative free midazolam treated rabbits showed significant histologic changes in light and fluorescence microscopy. The histologic and vascular lesions with the use of midazolam and preservative free midazolam suggested neurotoxic effects; thus chronic intrathecal administration of midazolam should be avoided in humans.